Infertility and Lactation: What a Lactation Consultant Wants You to Know
If you’ve experienced infertility, needed assisted reproductive technology (ART) like IVF or IUI, or navigated hormonal challenges to become pregnant, you may wonder what this means for breastfeeding. As an International Board Certified Lactation Consultant (IBCLC) candidate, I want you to know this first:
A history of infertility does not mean you can’t breastfeed, but it does mean thoughtful, proactive lactation support can make a meaningful difference. Understanding how infertility and lactation are connected helps us plan early, reduce stress, and support your body through this transition.
How Infertility Can Affect Lactation
Many of the same hormones required to achieve and sustain pregnancy are also essential for milk production. When fertility has been affected, lactation may be impacted, not always, but sometimes, depending on the underlying cause.
Common infertility-related factors that can influence lactation include:
History of infertility
Use of assisted reproductive technology (ART)
Hormonal imbalances (ex: low prolactin, high progesterone, high estrogen)
Thyroid or pituitary disorders (ex: Cushing’s syndrome, diabetes, Hashimoto’s, hypothyroidism)
Polycystic Ovary Syndrome (PCOS), a leading cause of infertility
Advanced maternal age
Placental insufficiency in pregnancy
None of these automatically mean low milk supply. But they do signal the importance of early assessment, individualized planning, and close follow-up with an IBCLC.
The Hormonal Bridge Between Pregnancy & Lactation
The groundwork for lactation doesn’t begin at birth, it begins during puberty when the breasts are developing and again in pregnancy. Breast development and milk-making capacity are hormonally programmed long before your baby arrives. The breasts store colostrum (baby’s first milk) as early as 16 weeks gestation.
7 Key Hormones Involved in Lactation
Estrogen
Stimulates growth of milk ducts promotes growth of ducts, breast fat and initial growth of alveolar cells and lobes during puberty and pregnancy
From the ovaries and placenta
Important note: High estrogen levels inhibit milk secretion, which is why copious milk production begins only after birth, when estrogen levels fall
Progesterone
Promotes growth of milk-producing alveoli (small grape like clusters in the breasts)
From the ovaries and placenta
Important note: Progesterone inhibits prolactin during pregnancy; progesterone levels drop dramatically (about 10-fold) in the first 1–4 days postpartum, allowing milk production to begin (aka “lactogenesis 2”)
Prolactin
Drives milk production and the production of milk-making cells called “lactocytes”
From the anterior pituitary gland
Triggered by nipple stimulation and milk removal
Can be decreased by: smoking, untreated depression, obesity, pituitary disorders
Oxytocin
Triggers milk let-down (milk ejection reflex). Oxytocin also supports bonding and causes some uterine contractions after birth when baby is suckling.
Produced in the hypothalamus, released by the posterior pituitary
Triggered by suckling, skin-to-skin, baby’s cry, emotional connection
Stress inhibits oxytocin, which can affect milk flow even when milk production is adequate.
Human Placental Lactogen (hPL)
Prepares breast tissue for lactation during pregnancy. Works with estrogen and progesterone to stimulate alveolar and areolar growth
From the placenta
Cortisol
Necessary in small amounts. Chronically high levels of cortisol (stress, sleep deprivation) can inhibit lactation
From adrenal glands
Insulin
Supports survival of lactocytes (milk-making cells) and lactose synthesis
Insulin resistance (common with PCOS) can affect milk production for some parents
What Else Can Disrupt Lactation?
Even with adequate breast development and frequent demand from the baby or pump, lactation can be affected by:
Chronic or acute stress
Hormonal imbalances, including low prolactin
Infrequent or ineffective milk removal
Certain medications
Untreated thyroid or metabolic conditions
This is why lactation success is rarely about “trying harder,” it’s about supporting the physiology.
Guidance for Parents With a History of Infertility
If you’ve experienced infertility or hormonal challenges, these steps can significantly improve outcomes:
Schedule a prenatal IBCLC consultation
This allows us to:
Review your medical and fertility history
Assess breast development
Identify risk factors early
Create a personalized feeding plan
2. Make a plan for early hand expression
Hand expression in the first hours and days after birth can:
Support early milk production
Increase prolactin receptor development
Provide colostrum if supplementation is needed
3. Arrange early postpartum, in-person support
The first days matter. Timely assessment of latch, milk transfer, and infant feeding behaviors can prevent common challenges from becoming long-term struggles.
Compassionate Support Makes a Difference
Many parents who have experienced infertility carry extra emotional weight into the postpartum period, fear of failure, pressure to “get it right,” or grief layered with joy. These experiences deserve care, not judgment.
Working with an IBCLC who understands infertility, hormonal physiology, and emotional context can be deeply grounding, and can change the trajectory of your feeding experience.
If you have a history of infertility, PCOS, hormonal imbalance, or using ART, or if you simply want a thoughtful, proactive plan, I invite you to schedule a lactation consultation. Together, we can:
Build a realistic, supportive feeding plan
Optimize milk production and transfer
Reduce stress and uncertainty
Support both your body and your emotional well-being
Your feeding journey deserves expertise, compassion, and individualized care. 👉 Book a prenatal or postpartum lactation appointment today
Written by Kathleen Stern (bio here). For more infant feeding and parent support, reach out to Kathleen at www.strongnestconsulting.com
Last updated December 18, 2025